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Can States Take the Lead in Health Care Reform?

Creator

Moon, Marilyn

Holahan, John

Bibliographic Citation

JAMA. 1992 Sep 23/30; 268(12): 1588-1594.

Abstract

Enthusiasm for tackling problems with health care reform is not limited to the federal level. The slow pace of decision making at the federal level and the sense of crisis often surrounding states' Medicaid programs have helped to spur states into making their own plans. Several states already have implemented or sought to implement major changes in their health care systems. A number of other states have engaged in serious discussions about policy changes that could result in major reform of their health care systems....This article provides a brief overview of some of the major proposals [for reform of state health plans]. Describing the full range of proposals would be a task beyond this paper; well over a majority of states are considering major plans. Thus, we have chosen to describe only a few of these proposals, which are indicative of current thinking on the issue. We then propose a role that the federal government could play to ensure that a state-based approach would be successful in achieving universal coverage for the United States as a whole.